PubMed Health⌕ Search

Biomedical subjects

M Croitoru

Publications and source records attributed to M Croitoru.

At least 19 recordsLinked to original sources
PubMed2005

Intraductal papillary mucinous neoplasm of the pancreas in a patient with attenuated familial adenomatous polyposis.

A 67 year old man with a clinical diagnosis of attenuated familial adenomatous polyposis (AFAP) and a past history of synchronous colon cancers in the transverse colon was also found to have an intraductal papillary mucinous neoplasm (IPMN) of the pancreas. In addition, several foci of heterotopic gastric oxyntic mucosa were noted in the duodenum, interspersed with flat and polypoid adenomas. The duodenal adenomas showed low grade dysplasia, loss of adenomatous polyposis coli (APC) protein expression, but retention of beta catenin staining, localised to the nucleus and cytoplasm. The IPMN in the pancreas showed an identical immunohistochemical profile to the duodenal adenomas. The heterotopic gastric foci in the duodenum were negative for the APC protein, and beta catenin staining was membranous in location. Although the patient did not show germline truncating APC mutations or mutations in the MYH gene, the past history, clinical features, and immunohistochemical profile of the various lesions suggest strongly that the IPMN is part of the spectrum of lesions encountered in AFAP. Whether the heterotopic oxyntic gastric mucosa in the duodenum is also related is unclear, but it may represent a forme fruste of fundic gland polyps.

Adenomatous Polyposis Coli↗
PubMed2001

The Combitube in elective surgery: a report of 200 cases.

BACKGROUND: The Combitube has proved to be a valuable device for securing the airway in cases of difficult intubation. This study investigated the effectiveness of the Combitube in elective surgery during both mechanical and spontaneous ventilation. METHODS: Two hundred patients classified as American Society of Anesthesiologists physical status I and II, with normal airways, scheduled for elective surgery were randomly allocated into two groups: nonparalyzed, spontaneously breathing (n = 100); or paralyzed, mechanically ventilated (n = 100). After induction of general anesthesia and insertion of the Combitube, oxygen saturation, end-tidal carbon dioxide and isoflurane concentration, systolic and diastolic blood pressure and heart rate, as well as breath-by-breath spirometry data were obtained every 5 min. RESULTS: In 97% of patients, it was possible to maintain oxygenation, ventilation, and respiratory mechanics, as well as hemodynamic stability during either mechanical or spontaneous ventilation for the entire duration of surgery. The duration of surgery was between 15 and 155 min. CONCLUSIONS: The results of this study suggest that the Combitube is an effective and safe airway device for continued management of the airway in 97% of elective surgery cases.

Adult↗
PubMed2000

The influence of preemptive spinal anesthesia on postoperative pain.

STUDY OBJECTIVE: To examine the influence of spinal anesthesia on postoperative pain and postoperative opioid requirements. DESIGN: Prospective randomized study. SETTING: Bnai-Zion Medical Center, Haifa, Israel-a government hospital. MEASUREMENTS AND MAIN RESULTS: 30 ASA physical status I and II unpremedicated women undergoing elective total abdominal hysterectomy were randomly allocated into two groups of 15 patients each using a sealed envelope technique. Patients in Group 1 were given a subarachnoid injection of 12 mg hyperbaric bupivacaine and after 10 minutes general anesthesia was induced. Patients in Group 2 received only general anesthesia. Anesthesia was induced with midazolam and maintained with oxygen, N2O, isoflurane, and pancuronium. No opioids were given intraoperatively. Postoperatively patient-controlled analgesia (PCA) with morphine was initiated in both groups (1 mg x mL(-1), bolus dose 1 mg, lockout interval 10 minutes, and background infusion 1 mg x mL(-1)) at patient first request for analgesic. Pain was assessed over 24 hours by cumulative morphine dose and visual analog score (VAS). Postoperative PCA morphine consumption at 2, 6, and 24 hours following patient first request for analgesic for Groups 1 and 2 were: 3.1 +/- 1 mg versus 7.2 +/- 3 mg (p = 0.04), 13.4 +/- 2 mg versus 17.2 +/- 4 mg (p = 0.03) and 35.9 +/- 8 mg versus 47.7 +/- 8 mg in Group 2 (p = 0.04). VAS scores at 4, 6, 12, and 24 hours postoperatively were not significantly different between the two groups. CONCLUSIONS: Preoperative neural blockade may reduce postoperative analgesic requirements.

Adult↗
PubMed2000

Local thrombolytic treatment for renal arterial embolism.

OBJECTIVE: To determine the utility of local thrombolysis in the treatment of acute renal arterial occlusion. METHODS: We used local thrombolytic treatment in a female patient, aged 76, with 72 h of anuria, right lumbar and flank pain. She had a 3-year history of ischemic heart disease and atrial fibrillation controlled with digital treatment. Also, she was nephrectomized on the left side 33 years ago for lithiasic pyonephrosis. A normal right urinary tract was demonstrated with ultrasound examination, KUB radiography and retrograde pyelography. The next step was diagnostic abdominal angiography and local thrombolytic treatment with streptokinase. RESULT: Thrombolysis with streptokinase was successful following 72 h of renal artery occlusion. After 24 months the patient is doing well. CONCLUSION: Local intra-arterial thrombolysis is the treatment of choice in renal artery occlusion.

Acute Disease↗
PubMed1999

Acute renal failure following laparoscopic cholecystectomy: a case report.

The carbon dioxide (CO2) pneumoperitoneum of laparoscopic surgery is a complex physiologic event associated with neuroendocrine, respiratory, cardiovascular, and renal disturbances, as well as compromised organ blood flow. A case is presented of a 67-year-old man with a history of chronic renal failure, renal tubular acidosis, and hypertension, who underwent an uneventful elective laparoscopic cholecystectomy that included 75 minutes of CO2 pneumoperitoneum of 15 mmHg pressure. Postoperatively, the patient developed acute renal failure from which he recovered within 2 weeks. In the absence of other evident precipitating factors, we suspect that the CO2 pneumoperitoneum played a causal role in the development of his acute renal failure. The potential seriousness of the physiologic insult of conventional CO2 pneumoperitoneum suggests that "minimal access" surgery is not necessarily "minimally invasive."

Acute Kidney Injury↗
PubMed1998

Failure to control the airway in a patient with Hunter's syndrome.

Hunter's syndrome is due to recessively inherited mucopolysaccharide storage diseases. The anaesthetic complications in this syndrome are related to the organs involved in the disease, but pertain especially to upper airway obstruction problems. We report a patient with Hunter's syndrome who, while under general anaesthesia for a simple procedure (the introduction of bilateral grommets), suffered a fatal outcome.

Adolescent↗
PubMed1997

A clinical, epidemiological and laboratory study on avoiding the risk of transmitting viral hepatitis during vaccinations with the Dermojet protected by an anticontaminant disposable device.

Jet injectors may transmit blood-borne infections, such as hepatitis B virus (HBV) and human immunodeficiency virus (HIV). To evaluate the safety of an anticontaminant disposable device which protects the jet injector apparatus, 22,714 healthy subjects were intradermally inoculated (38,162 inoculations) with a variety of vaccines. All the subjects were systematically followed-up clinically and epidemiologically for 6-18 months after inoculation; blood samples from 1619 subjects, before and 60-75 days after inoculation, were examined by enzyme-linked immunosorbent assay (ELISA) for HBV, hepatitis C virus (HCV) and HIV. Before vaccination 212 (13.09%) subjects were positive: 204 positive for HBV markers and eight for the HCV marker. None of the subjects were positive for the anti-HIV marker. During the clinico-epidemiological surveillance and the laboratory investigations mentioned above no clinical viral hepatitis B or C case and no seroconversion to positivity for HBV or HCV markers among the susceptible persons in the group were reported. Considering that in similar situations there is a theoretical risk of transmission as high as 1 per 388 to 1 per 3367 injections and that in our case 38,162 inoculations were performed in 22,714 subjects with the same Dermojet protected by the same type of anticontaminant disposable device, no contamination risk being reported, the conclusion can be reached that jet injectors can be safely used in the medical practice if they are protected by the sterile anticontaminant disposable device.

Adolescent↗
PubMed1994

Drug delivery systems based on inorganic materials: I. Synthesis and characterization of a zeolite-cyclophosphamide system.

Porous material of the CuX zeolite type has been synthesized and used as support for a classic antitumoral drug--cyclophosphamide (CP). The new material obtained represents a physical mixture of the two components. In vivo tests allowed biochemical and anatomopathological evaluation of antitumoral effects determined by oral administration of the CuX zeolite-CP system. Data obtained show that the intensity of the antitumoral effects of the CuX zeolite-CP system is similar as compared to that achieved by CP. A possible advantage of the CuX zeolite-CP system is the continual maintenance in the blood of a CP concentration ranging between 100 and 1,000 ng ml-1 plasma.

Animals↗
PubMed1983

Lyophilized typhoid vaccine for intradermal use.

The prophylaxis of typhoid fever in Romania is usually achieved with fluid heat-killed phenolized vaccine. However the shelf life of this vaccine is only two years. The long term storage of an intradermal typhoid vaccine is made possible by lyophilization. A heat-inactivated bacterial suspension with a high concentration of organisms, at least 25 X 10(9) cells per ml, was freeze-dried at a temperature not higher than 30 degrees C. The final vaccine obtained had a residual moisture content of not more than 5%. Active and passive protection tests in mice, specific agglutinin production in humans and rabbits, the innocuity and the toxicity for mice, and the investigation of post-vaccinal adverse reactions in man, showed that the lyophilized typhoid vaccine could be stored at 4 degrees C for at least five years without loss of potency. Consequently, the vaccine may be stored without risk of deterioration for rapid emergency mass immunization with Jet-injector apparatus.

Animals↗
PubMedDate not supplied

Using rate-based events to improve clinical practice.

This article describes the implementation and utilization of a continuous quality improvement (CQI) program in the identification, analysis, and correction of a rate-based event in anesthesia, in this case, intraoperative hypertension. A CQI program was implemented based on voluntary, handwritten, anonymous reports of intraoperative and postanesthesia care unit events. This CQI program detected a high incidence of intraoperative hypertension, indicated major causal factors, suggested a set of corrective measures, and allowed for measurement of their efficacy.

Anesthesiology↗